Pain doctors and patients say they were shut out of opioid conference in Ottawa

Chronic pain patients and doctors say they are baffled and worried after being denied access to a major federal opioid conference and summit being held in Ottawa on Friday.

Doctors who prescribe opioids and the patients who use them say doors to the invitation-only conference, co-hosted by federal Health Minister Jane Philpott and Ontario Health Minister Eric Hoskins, were closed to them.

“If governments are claiming that doctors prescribing opioids for pain are the cause of the current opioid crisis, then surely we should be at the table discussing solutions that will reduce the harms of opioids — but will not punish our patients with pain,” said Dr. Roman Jovey.

Jovey, the Mississauga-based medical director at CPM Centres for Pain Management, fears it means pain doctors won’t have a place at the table as Canada determines strategies for managing its opioid crisis.

The conference is aimed at discussing ways to reduce harm related to opioids. It will be followed on Saturday by an “opioid summit” that is to produce a joint statement of action. Meanwhile,only six weeks remain before the Ontario government stops paying for some higher-strength, long-acting opioids.

There were 685 overdose deaths in Ontario in 2014 alone.

Jovey said Health Canada officials told him there wasn’t room for everyone who wanted to attend the conference but that there would be a webcast.

“We have limited seating at the Opioid Conference, and unfortunately cannot accommodate all organizations that are interested in attending,” said an email from a Health Canada official in response to his request. “I would like to assure you that several representatives will be in attendance from pain and palliative care networks. In addition, the conference will be available through webcast.”

Health Canada said in a separate emailed statement that members of the public would be able to view the live webcast.

Jovey asked his colleagues whether they were attending but none had been invited.

“It’s a stacked agenda. How can you have a reasonable solution without doctors who treat pain and pain patients? No one will talk about the possibility that opiates may possibly be helpful.”

Dr. Chris Giorshev, head of the Ontario Medical Association section on chronic pain, said he couldn’t understand why conference organizers would exclude physicians with expertise and experience in safe and effective prescribing of opioids.

“I think the entire emphasis has been on the addictions side. The concern is that the conference is one-sided and does not reflect the best interests of all patients. We think we have a lot to offer and we want to be part of the process,” said Giorshev, who treats both chronic pain and addictions patients in his Barrie, Ont. practice.

Fifteen to 20 per cent of the Canadian population suffers from moderate or chronic pain, he said.

“A lot of patients are doing well on opioids. They have jobs, they have families. The vast majority of people on opioid medications don’t sell them on the streets. If you look at addictions, some come from (prescription) diversions. But much of the fentanyl comes illegally from China.”

Chronic pain patients who hoped to attend the conference, even as observers, say they were also turned away. Ottawa’s Marisa Robertson said she was told she could watch the webcast.

“I wanted an opportunity to buttonhole someone and show them a person who has been in pain every day,” said Roberston, 54, who has had chronic pain ever since she injured her back as a competitive gymnast in her teens.

“The politicians want to do something about the horrible scourge of addictions. The easiest, fastest thing to do is remove access. But there are legitimate users who will have no access.”

Some patients, like Robertson, have already reduced their use of opioids, but fear they will be cut off entirely.

Billie Jo Bogden, 46, also reduced her use of opioids in anticipation of Ontario’s delisting of certain products. But it was a long and painful process that was only possible with the support of her doctor.

Bogden says many other pain patients don’t have the same resources. She wanted to bring their perspectives to the conference but got turned away. “I have banged on every door I could think of.”

Martie Whitaker, 56, who has had chronic pain since she fractured her spine in 1998, said she was also refused a spot.

Whitaker fears that when her doctor retires, no one else will be willing to take her on as a patient. “They need to know that pain patients take opioids responsibly.”

Dr. Fiona Campbell, president-elect of the Canadian Pain Society, was invited to the conference, but she will not be speaking.

The purpose of the summit is to present “deliverables” to help address the crisis, said Campbell. One of the commitments the Canadian Pain Society plans to make is an assurance that any strategy will contain measures to assure that opioid analgesics “remain available to those patients who require them for appropriate medical use, and that these individuals are treated compassionately.”

Campbell, who is a staff anesthesiologist at The Hospital for Sick Children in Toronto, said there will be comprehensive group of guests at the conference, including two pain patients.

She said she can understand why organizers kept numbers down. “The likelihood to get a deliverable that is deliverable is inversely proportional to the number of people there.”

Jovey was hoping to get a last-minute invitation, but it doesn’t appear that will happen.

“The idea is that opioids are evil substances that shouldn’t be used by anybody. They’re just a tool, but they’re an important tool,” he said. “I’m all for safety and reducing risk. But let’s not make people suffering from chronic pain the collateral damage.”

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